Multiply-funded program that scans medication profiles in near-realtime to identify children at risk for Acute Kidney Injury (AKI), passive notification of pharmacists.

Image from AKI NINJA project.

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Clinical Rationale/Problem Solved

Medication-associated AKI is underrecognized,  causes a lot of morbidity, and is a costly safety issue

Potential Impact

We have shown dramatic improvements in both risk and injury, cutting both by >65-70%. 

DSAW Investigators

Eric Kirkendall


Stuart Goldstein (PI), Katie Walsh, Steve Muething


"AHRQ R18 Grant #5R18HS023763 (Peer-reviewed) 
“NINJA2: Reduction of Nephrotoxic Medication-associated Acute Kidney Injury in Children”
Principal Investigator: Stuart Goldstein, MD

Casey Lee Ball Foundation extramural grant
“Reduction of Nephrotoxic Medication Associated Acute Kidney Injury in Children”
Principal Investigator: Stuart Goldstein, MD
Role: Co-investigator
Role: Co-investigator

Agency for Healthcare Research and Quality Grant #U19HS021114 (Peer-reviewed)
“Pursuing Perfection In Pediatric Therapeutics”
Principal Investigator: Carole Lannon, MD"


Goldstein SL, Mottes T, Simpson K, Barclay C, Muething S, Haslam DB, Kirkendall ES. A sustained quality improvement program reduces nephrotoxic medication-associated acute kidney injury. Kidney Int. 2016 Jul;90(1):212-21.

Menon S, Kirkendall ES, Nguyen H, Goldstein SL. Acute kidney injury associated with high nephrotoxic medication exposure leads to chronic kidney disease after 6 months. J Pediatr. 2014 Sep;165(3):522-7.e2.

Kirkendall ES, Spires WL, Mottes TA, Schaffzin JK, Barclay C, Goldstein SL. Development and performance of electronic acute kidney injury triggers to identify pediatric patients at risk for nephrotoxic medication-associated harm. Appl Clin Inform. 2014 Apr 2;5(2):313-33. 

Goldstein SL, Kirkendall E, Nguyen H, Schaffzin JK, Bucuvalas J, Bracke T, Seid M, Ashby M, Foertmeyer N, Brunner L, Lesko A, Barclay C, Lannon C, Muething S. Electronic health record identification of nephrotoxin exposure and associated acute kidney injury. Pediatrics. 2013 Sep;132(3):e756-67.